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Detroit man pleads guilty in $13

An FBI news release announces that a Detroit area resident pled guilty Tuesday, August 28, 2012, in federal court in the Eastern District of Michigan for his role in managing a $13.8 million psychotherapy fraud scheme, announced the Department of Justice, the Department of Health and Human Services (HHS), and the FBI.

Detroit man pleads guilty in $13

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Detroit man pleads guilty in $13.8million health care fraud scheme

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An FBI news release announces thata Detroit area resident pled guiltyTuesday, August 28, 2012, in federalcourt in the Eastern District ofMichigan for his role in managing a$13.8 million psychotherapy fraudscheme, announced the Departmentof Justice, the Department of Healthand Human Services (HHS), and theFBI.

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Jawad Ahmad, 42, pleaded guilty beforeU.S. District Judge Gerald E. Rosen inDetroit to one count of conspiracy tocommit health care fraud. At hissentencing, scheduled for November 28,2012, Ahmad faces a maximumpotential penalty of 10 years in prisonand a $250,000 fine.The guilty plea was announced byAssistant Attorney General Lanny A.Breuer of the Justice Department’sCriminal Division; U.S. Attorney for theEastern District of Michigan Barbara L.

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Special Agent in Charge of the FBI’sDetroit Field Office Robert D. Foley III; andSpecial Agent in Charge Lamont Pugh IIIof the HHS Office of Inspector General’s(HHS-OIG) Chicago Regional Office.According to court documents, beginningin July 2008, two of Ahmad’s co-conspirators, Tausif Rahman andMuhammad Ahmad, acquired control overa home health care company known asPhysicians Choice Home Health Care LLC(Physicians Choice). From in or aroundJanuary 2009 and continuing through in oraround March 2010, Jawad Ahmadmanaged the operations of PhysiciansChoice.

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In exchange for kickbacks, Medicarebeneficiaries pre-signed forms and visitsheets that were later falsified to indicatethey received home health services they hadnever received. Jawad Ahmad delivered thepre-signed beneficiary paperwork to variousmedical professionals, including nurses,physical therapists, and physical therapyassistants to create and/or sign fictitiouspatient files to document purported homehealth services that were never rendered.From in or around January 2009 through inor around March 2010, Medicare paid morethan $5 million for fraudulent home healthcare claims submitted by Physicians Choice.

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According to court records, from in oraround May 2010 through in or aroundSeptember 2011, Jawad Ahmad managedPhoenix Visiting Physicians PLLC, acompany incorporated by co-conspiratorDr. Dwight Smith. Dr. Smith signed homehealth care referrals for beneficiaries hehad not seen or treated. Phoenix employedindividuals who held themselves out to be“doctors,” but who were not, in fact,licensed in the state of Michigan to performany medical services. The unlicensed“doctors” met and purported to examinenon-homebound Medicare beneficiaries forhome health care services. Jawad Ahmaddrove one unlicensed “doctor” to meet andpurportedly examine beneficiaries whowere not, in fact, homebound.

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Between 2008 and 2009, Ahmad’s co-conspirators acquired beneficial ownership andcontrol over three additional home health carecompanies: First Care Home Health Care LLC,Quantum Home Care Inc., and Moonlite HomeCare Inc. Each of these home health companiesbilled Medicare and operated in a manner thesame as or similar to Physicians Choice. Each ofthese companies received fraudulent homehealth referrals from Dr. Smith through PhoenixVisiting Physicians. From in or around May 2010through in or around September 2011, Medicarepaid more than $5 million for fraudulent homehealth care claims submitted by PhysiciansChoice, First Care, Quantum, and Moonlitebased on Dr. Smith’s fraudulent referrals.

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The four home health companies at thecenter of the indictment receivedapproximately $13.8 million fromMedicare in the course of theconspiracy.Eight other defendants have pleadedguilty in this case, including TausifRahman and Muhammad Ahmad, whoeach pleaded guilty to one count ofconspiracy to commit health care fraudand one count of money laundering, aswell as Dr. Dwight Smith who pleadedguilty to one count of conspiracy to

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The case is being prosecuted by TrialAttorney Catherine K. Dick of theCriminal Division’s Fraud Section. Thecase was investigated by the FBI andHHS-OIG and was brought as part oftheMedicare Fraud Strike Force,supervised by the Criminal Division’sFraud Section and the U.S. Attorney’sOffice for the Eastern District ofMichigan.

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Since its inception in March 2007, theMedicare Fraud Strike Force, nowoperating in nine cities across thecountry, has charged more than 1,330defendants who have collectively billedthe Medicare program for more than $4billion. In addition, HHS’s Centers forMedicare and Medicaid Services,working in conjunction with HHS-OIG,is taking steps to increaseaccountability and decrease thepresence of fraudulent providers.

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The public is encouraged to report anyactivity which appears to be fraudulentor illegal concerning Medicare andMedicaid providers. To learn moreabout the Health Care FraudPrevention and Enforcement ActionTeam (HEAT).